What is an aortic aneurysm?
The aorta is the main blood vessel of the body and is located within the chest and abdomen. It feeds the blood vessels that supply blood to the brain, internal organs, arms, and legs. An aortic aneurysm is a bulge or weakening of the aorta. This weakened area may grow larger with time and if it bursts or ruptures, could be life threatening. The abdominal section of the aorta is the most common place for an aneurysm to occur, but they can form in any blood vessel in the body.
Symptoms of an aneurysm
People rarely have symptoms from an aortic aneurysm. On physical examination, the doctor may feel a throbbing mass in your abdomen, however, most aneurysms are identified when a person has an x-ray, ultrasound test or CT scan for other reasons. If the aneurysm bursts or ruptures massive internal bleeding will occur, which may cause intense back or abdominal pain and signs of shock (ie; fainting, sweating, sudden weakness, and a rapid heartbeat).
Causes of an aneurysm
Factors that contribute to aneurysm formation are:
- Hypertension (high blood pressure)
- Atherosclerosis (hardening of the arteries)
Screening / Testing
Aneurysms rarely cause symptoms, but there are noninvasive ultrasound screening tests available.
An ultrasound or CT scan of the abdomen may be ordered by your doctor and is usually covered under your insurance.
There are two ways to repair an abdominal aortic aneurysm. One is an open abdominal operation to remove the aneurysm and inserting a graft or replacement material. The other is an endovascular stent graft which is a less invasive operation and performed from within the aorta.
Not every patient is a candidate for an endovascular graft. Your doctor will determine which is the best treatment for you. If an open abdominal operation is necessary, it is performed under general anesthesia and usually takes 2-4 hours. The surgeon replaces the diseased portion of the aorta with an aortic graft (strong, flexible tube made of Dacron plastic which the body cannot reject). This graft functions as a bridge connecting the normal artery above and below where the aneurysm was located.
During an endovascular stent graft procedure, the surgeon will make two small incisions in your groin. While watching an x-ray machine, a catheter tube with the graft is guided inside the artery to the aneurysm. The graft is placed within the aneurysm sac and forms a new lining within the aneurysm.
What should I ask my doctor?
How long will I stay in the hospital?
For the open abdominal operation, patients usually stay in the Intensive Care Unit between 1-3 days and then remain in the hospital another 2 to 7 days. For the endovascular graft procedure the hospital stay is usually 1-2 days.
What should I bring to the hospital?
Pack a small bag of personal hygiene items, and a list of your medications. Do not bring valuables.
What lifestyle changes are required after abdominal aneurysm surgery?
You will need to take it easy after your operation. It may be important to modify your lifestyle. Modifications include, but are not limited to:
- stopping smoking
- regulating your blood pressure and cholesterol
- changing your diet.
What type of anesthesia will I have?
The procedure is performed under general anesthesia for the open operation and possibly local anesthesia for the endograft.
How long can the stent graft stay in place?
The graft can stay in place for the rest of your life.
Who is a candidate for an endograft stent procedure?
Patients with favorable anatomy, are those with large arteries leading to the aneurysm and patients with an area in the aorta below the kidney arteries to anchor the stent graft. A CT scan can determine if you are a candidate for an endovascular graft procedure.an determine if you are a candidate for an endovascular graft procedure.
What follow-up procedures and care are necessary after an endovascular stent graft?
You will need to have follow-up visits on a regular basis to monitor the graft which will require ultrasound and/or CT scans on an annual basis.
It is important to be your own best health advocate. A good way to do that is by committing to routine physical exams and diagnostic tests as often as is recommended by your vascular specialist. Early detection of vascular disease is important for effective treatment.
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